MAGIC MART PHARMACY,INC (NPI# 1194804591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194804591 |
| Entity Type | Organization |
| Organization Name | MAGIC MART PHARMACY,INC |
| Practice Address |
903 Highway 82 E Bldg G Indianola MS 38751-2325 |
| Practice Telephone | 6628874135 |
| Practice Fax Number | 6628879703 |
| Mailing Telephone | 6628874135 |
| Mailing Fax Number | 6628879703 |
| Enumeration Date | 2006-11-04 |
| Last Update Date | 2019-12-19 |
| Authorized Official Name | GUY M MALONE (PRESIDENT) |
| Authorized Official Telephone | 6628874135 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 01301 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | MEDICAID DME | 00440170 | 01 |
| MS | NCPDP | 2517324 | 01 |
| MS | 00330007 | 05 | |
| MS | MEDICARE DME | 0966510001 | 01 |
| Street Address |
903 HIGHWAY 82 E BLDG G |
| City | INDIANOLA |
| State | MS |
| Zip Code | 38751-2325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841764636 | Robyn Soignier | Pharmacist | 903 Highway 82 E Bldg G, Indianola, MS 38751-2325 | 2019-01-15 |
| 1922187327 | Guy M Phillips | Pharmacist | 903 Highway 82 E Bldg G, Indianola, MS 38751-2325 | 2006-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649781253 | Greater Hearts Adult Daycare | Clinic/Center | 124 Curtis Street, Indianola, MS 38751 | 2017-10-23 |
| 1083139505 | Quality Family Care LLC | Nurse Practitioner | 310 Hwy 82 West, Suite D, Indianola, MS 38751 | 2017-08-05 |
| 1932641800 | Creative Image Personal Care Services LLC | Respite Care | 503 Hwy 82 East, Indianola, MS 38751 | 2016-11-09 |
| 1225580442 | St. John's Respite Care Services, LLC | In Home Supportive Care | 517 East Street, Indianola, MS 38751 | 2016-11-04 |
| 1992163588 | Rona Kaye Huey | Nurse Practitioner | 310 Highway 82 W Ste D, Indianola, MS 38751 | 2016-02-10 |
| 1952641201 | Julia R. Hill, Dmd, Pa | Dentist | 104 W. Gresham St., Indianola, MS 38751 | 2013-02-25 |
| 1649463977 | Kenneth C Beal Jr. | Dentist | 913 B.b. King Road, Indianola, MS 38751 | 2007-08-21 |
| 1922136688 | Lloyd Leon Patton Jr. | Pharmacist | 903 Highway 82 East, Building G, Indianola, MS 38751 | 2007-03-02 |
| 1770623506 | North Mississippi Foot Specialists PC | Durable Medical Equipment & Medical Supplies | 110 East Baker Street, Indianola, MS 38751 | 2007-02-08 |
| 1548311525 | Quality In Home Services Inc | Homemaker | 108 Martin Luther King, Indianola, MS 38751 | 2007-01-16 |
| Find all providers in zip 38751 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336177393 | Freds Stores of Tennessee Inc | Pharmacy | 210 Highway 82 W, Indianola, MS 38751-2133 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457973067 | Thomas Street Compounding Pharmacy | Pharmacy | 115 N Thomas St Ste G, Tupelo, MS 38801-3082 | 2020-05-18 |
| 1013558824 | Downhome Pharmacy, Inc. | Pharmacy | 606 W. Broad St, Monticello, MS 39654 | 2019-10-02 |
| 1356997985 | Sonshine Pharmacy, LLC | Pharmacy | 2745 Highway 371 N, Mantachie, MS 38855 | 2019-08-09 |
| 1699331868 | Fulton Specialty Pharmacy, LLC | Pharmacy | 1509 S Adams St Ste D, Fulton, MS 38843-6621 | 2019-05-14 |
| 1063971539 | National Pharmacy of Mississippi, LLC | Pharmacy | 371b Highland Colony Pkwy, Ridgeland, MS 39157-6035 | 2019-03-14 |
| 1811468952 | Davidson Pharmacy, LLC | Pharmacy | 203a N 2nd St, Booneville, MS 38829-2701 | 2018-12-16 |
| 1346710720 | Tupelo Specialty Pharmacy, LLC | Pharmacy | 1056 Cliff Gookin Blvd Ste C, Tupelo, MS 38801-6458 | 2018-11-28 |
| 1205302254 | A & A Infusion & Specialty, LLC | Pharmacy | 423 Mcallister St, Greenville, MS 38701-4704 | 2018-10-17 |
| 1306325402 | Family Drug Mart of Poplarville,llc | Pharmacy | 100 Highway 11 N, Poplarville, MS 39470-2217 | 2018-08-09 |
| 1851883789 | Amory Discount Pharmacy, LLC | Pharmacy | 60379 Cotton Gin Port Rd Ste B, Amory, MS 38821-7204 | 2018-06-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MAGIC MART PHARMACY,INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.